Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington and Camden)
Assemblyman JACK CONNERS
District 7 (Burlington and Camden)
SYNOPSIS
Requires health care facilities to continuously monitor status of health care practitioner credentials.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the monitoring of health care practitioners by health care facilities and supplementing Title 26 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The Legislature finds and declares that:
a. Everyday, patients in New Jersey may be put in jeopardy by health care practitioners with questionable credentials who are providing health care services in hospitals, ambulatory surgery facilities, nursing homes, home health care agencies, and other health care facility settings;
b. The need for consistent and continuous monitoring of health care practitioner credentials is essential to the public interest of providing quality health care in this State; and
c. It is, therefore, in the public interest to require that health care facilities continuously monitor health care practitioner license and other background information as a condition to the provision of, and payment for, health care services in New Jersey.
2. As used in this act:
"Health care facility" or "facility" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Health care practitioner" or "practitioner" means a person licensed, certified, or otherwise authorized to engage in a health care profession pursuant to Title 45 of the Revised Statutes or other State law or regulation, including, but not limited to, a physician, dentist, optometrist, psychologist, pharmacist, nurse, nurse aide, homemaker-home health aide, physician assistant, personal care assistant, respiratory therapist, physical therapist, occupational therapist, or speech therapist.
3. a. A health care facility, subsequent to credentialing or employing a health care practitioner, as applicable, shall monitor, no less than twice monthly, for any changes in the status of the following by checking the applicable primary sources for each:
(1) the practitioner's current license, certification, or other authorization to practice in all states in which the practitioner practices;
(2) the practitioner's current New Jersey controlled substances registration and federal Drug Enforcement Administration registration, when applicable; and
(3) whether the practitioner is excluded from receiving federal contracts, subcontracts, or benefits as set forth in the Excluded Parties List System maintained by the federal General Services Administration, when applicable.
b. A health care facility shall maintain auditable records demonstrating that it has conducted continuous monitoring of health care practitioners, including copies of the information received from the applicable primary source with the date and time of each inquiry, and shall make these records available for inspection by the Department of Health and Senior Services and patients.
c. In any case in which a health care facility receives documentation demonstrating that a health care practitioner's authority to engage in practice is revoked or is currently subject to a final or interim order of active suspension or other bar to clinical practice by any other state, agency, or authority, the facility shall immediately suspend the practitioner from practicing at or on behalf of the facility when the action is grounded on facts that reasonably demonstrate, in the determination of the facility, that continued practice would endanger or pose a risk to the public health or safety.
d. If a health care practitioner's authority to engage in practice is revoked or is currently subject to a final or interim order of active suspension or other bar to clinical practice by any other state, agency, or authority, the practitioner and the health care facility employing or contracting with the health care practitioner shall not be entitled to seek reimbursement from a patient or third party for otherwise covered services during the pendency of the prohibition on the practitioner's clinical practice.
4. The Commissioner of Health and Senior Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this act.
5. This act shall take effect on the 180th day after enactment, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill requires health care facilities to continuously monitor the status of health care practitioner credentials.
The bill provides specifically as follows:
· The bill defines:
-- "health care facility" or "facility" to mean a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.); and
-- "health care practitioner" or "practitioner" to mean a person licensed, certified, or otherwise authorized to engage in a health care profession by law or regulation, including, but not limited to, a physician, dentist, optometrist, psychologist, pharmacist, nurse, nurse aide, homemaker-home health aide, physician assistant, personal care assistant, respiratory therapist, physical therapist, occupational therapist, or speech therapist.
· A health care facility, subsequent to credentialing or employing a practitioner, as applicable, is required to monitor, no less than twice monthly, for any changes in the status of the following by checking the applicable primary sources for each:
-- the practitioner's current license, certification, or other authorization to practice in all states in which the practitioner practices;
-- the practitioner's current New Jersey controlled substances registration and federal Drug Enforcement Administration registration, when applicable; and
-- whether the practitioner is excluded from receiving federal contracts, subcontracts, or benefits as set forth in the Excluded Parties List System maintained by the federal General Services Administration, when applicable.
· A health care facility is to maintain auditable records demonstrating that it has conducted continuous monitoring of health care practitioners, including copies of the information received from the applicable primary source with the date and time of each inquiry, and make these records available for inspection by the Department of Health and Senior Services and patients upon request.
· In any case in which a health care facility receives documentation demonstrating that a health care practitioner's authority to engage in practice is revoked or is currently subject to a final or interim order of active suspension or other bar to clinical practice by any other state, agency or authority, the facility is to immediately suspend the practitioner from practicing at or on behalf of the facility when the action is grounded on facts that reasonably demonstrate, in the determination of the facility, that continued practice would endanger or pose a risk to the public health or safety.
· If a health care practitioner's authority to engage in practice is revoked or is currently subject to a final or interim order of active suspension or other bar to clinical practice by any other state, agency or authority, the practitioner and the health care facility employing or contracting with the health care practitioner are not entitled to seek reimbursement from a patient or third party for otherwise covered services during the pendency of the prohibition on the practitioner's clinical practice.
· The bill takes effect on the 180th day after enactment, but authorizes the Commissioner of Health and Senior Services to take anticipatory administrative action in advance as necessary for its implementation.